Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis
Cardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloi...
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MDPI AG
2025-05-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/5/190 |
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| author | Aravind Dilli Babu Mirza Faris Ali Baig David A. Baran Jerry Estep David Wolinsky Nina Thakkar Rivera Ram Bhutani Harshit Narula Prashant Chaulagain David Snipelisky |
| author_facet | Aravind Dilli Babu Mirza Faris Ali Baig David A. Baran Jerry Estep David Wolinsky Nina Thakkar Rivera Ram Bhutani Harshit Narula Prashant Chaulagain David Snipelisky |
| author_sort | Aravind Dilli Babu |
| collection | DOAJ |
| description | Cardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloidosis, utilizing data from the National Inpatient Sample (2018–2021). Among 2,444,699 patients hospitalized for decompensated diastolic HF, 9205 (0.3%) had a documented secondary diagnosis of amyloidosis. After 1:1 propensity-score matching, 1841 patients in each group were analyzed. Multivariate logistic regression revealed that the presence of amyloidosis was associated with significantly higher odds of in-hospital mortality (4.0% vs. 2.7%), cardiogenic shock (5.4% vs. 2.4%), acute kidney injury (28.3% vs. 22.0%), ventricular tachycardia (12.4% vs. 6.0%), and acute myocardial injury (9.5% vs. 6.0%) (all <i>p</i> < 0.05). Additionally, patients with amyloidosis had a longer mean length of stay (7.1 vs. 5.7 days) and higher mean hospitalization costs ($85,594 vs. $48,484, <i>p</i> < 0.05). Although the overall incidence of acute myocardial injury was elevated, subgroup analysis of ST-elevation and non–ST-elevation myocardial infarction revealed no significant differences. These findings underscore the considerable clinical and economic burden of amyloidosis in patients hospitalized with decompensated diastolic heart failure. |
| format | Article |
| id | doaj-art-67dd9d87190d4fc0a964e34fe5d6c2cb |
| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-67dd9d87190d4fc0a964e34fe5d6c2cb2025-08-20T03:14:35ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-05-0112519010.3390/jcdd12050190Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched AnalysisAravind Dilli Babu0Mirza Faris Ali Baig1David A. Baran2Jerry Estep3David Wolinsky4Nina Thakkar Rivera5Ram Bhutani6Harshit Narula7Prashant Chaulagain8David Snipelisky9Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USADepartment of Internal Medicine, Asante Three Rivers Medical Center, Grants Pass, OR 97527, USAAdvanced Heart Failure and Transplantation Section of Heart Failure & Cardiac Transplant Medicine, Cleveland Clinic, Weston, FL 33331, USADepartment of Cardiology, Cleveland Clinic, Weston, FL 33331, USADepartment of Cardiology, Cleveland Clinic, Weston, FL 33331, USAAdvanced Heart Failure and Transplantation Section of Heart Failure & Cardiac Transplant Medicine, Cleveland Clinic, Weston, FL 33331, USADepartment of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USADepartment of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USADepartment of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USADepartment of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USACardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloidosis, utilizing data from the National Inpatient Sample (2018–2021). Among 2,444,699 patients hospitalized for decompensated diastolic HF, 9205 (0.3%) had a documented secondary diagnosis of amyloidosis. After 1:1 propensity-score matching, 1841 patients in each group were analyzed. Multivariate logistic regression revealed that the presence of amyloidosis was associated with significantly higher odds of in-hospital mortality (4.0% vs. 2.7%), cardiogenic shock (5.4% vs. 2.4%), acute kidney injury (28.3% vs. 22.0%), ventricular tachycardia (12.4% vs. 6.0%), and acute myocardial injury (9.5% vs. 6.0%) (all <i>p</i> < 0.05). Additionally, patients with amyloidosis had a longer mean length of stay (7.1 vs. 5.7 days) and higher mean hospitalization costs ($85,594 vs. $48,484, <i>p</i> < 0.05). Although the overall incidence of acute myocardial injury was elevated, subgroup analysis of ST-elevation and non–ST-elevation myocardial infarction revealed no significant differences. These findings underscore the considerable clinical and economic burden of amyloidosis in patients hospitalized with decompensated diastolic heart failure.https://www.mdpi.com/2308-3425/12/5/190amyloidosiscardiovascular diseaseheart failurepropensity score match |
| spellingShingle | Aravind Dilli Babu Mirza Faris Ali Baig David A. Baran Jerry Estep David Wolinsky Nina Thakkar Rivera Ram Bhutani Harshit Narula Prashant Chaulagain David Snipelisky Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis Journal of Cardiovascular Development and Disease amyloidosis cardiovascular disease heart failure propensity score match |
| title | Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis |
| title_full | Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis |
| title_fullStr | Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis |
| title_full_unstemmed | Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis |
| title_short | Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis |
| title_sort | comparative insights on inpatient outcomes in diastolic heart failure with and without amyloidosis a nationwide propensity matched analysis |
| topic | amyloidosis cardiovascular disease heart failure propensity score match |
| url | https://www.mdpi.com/2308-3425/12/5/190 |
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